October 23, 2012

Making a Case for Prevention

Investing in substance abuse prevention saves on health care costs.

Developing a strong substance abuse prevention workforce is a priority in many communities. But making sure that prevention staff have the tools they need to make informed programmatic decisions is often a challenge.

A new training course from the Center for the Application of Prevention Technologies (CAPT), housed at EDC and funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), is giving prevention specialists the support they need. The Substance Abuse Prevention Skills Training, or “SAPST” for short, covers the fundamentals of substance abuse prevention and reflects current research on effective practices in the field.

And with a focus on the science of prevention, the training stands to help improve the knowledge of early-career prevention professionals across the country.

Strategies for effective prevention

First created in 1997, the SAPST was revised in 2005. Then in 2009, an Institute of Medicine report documented the link between mental health and substance abuse, prompting a new look at the primary training tool for early-career prevention specialists.

The revised SAPST contains a number of improvements. For example, it emphasizes the importance of using data to guide all prevention-related decisions, from understanding the prevention needs of a community to monitoring how programs, policies, and strategies are delivered. Historically, programs have gathered data only for evaluation purposes.

“There are many interrelated issues in substance abuse prevention,” says EDC’s Melanie Adler. “It is essential for program staff to use data to guide all of their decisions, from identifying where to direct resources to evaluating results.”

The new SAPST takes a comprehensive approach to health. Carol Oliver, director of training and technical assistance for the CAPT, explains the change.

“The revision illustrates the idea that substance abuse prevention is part of a larger continuum,” she says. “Prevention programs that used to simply look at substance abuse are now looking at behavioral health. This approach requires a lot of coordination and collaboration across disciplines.”

However, prevention programs have not always emphasized best practices, according to Oliver.

“For a long time, people were spending a lot of time and money on a lot of programs that were ineffective,” she says, assessing substance abuse programs over the last two decades.

Over time and with new information, strategies for prevention have changed. Oliver gives one example of a tactic that used to be common: recovering addicts speaking about the personal toll of addiction in order to discourage drug use. “Some people might think this method is effective,” says Oliver. “But the research says just the opposite.”

Saving money, lives

The new SAPST’s emphasis on data-based decision making is intended to promote informed decisions about what works—and what doesn’t. This approach also puts it in line with SAMHSA’s Strategic Prevention Framework, a core set of principles that undergirds federally funded prevention programs.

In fact, research has shown that prevention programs are a cost-effective way of lowering the financial burden of substance abuse incurred by states.

In a 2008 study, researchers from SAMHSA identified the potential cost savings of substance abuse prevention efforts in school-based settings. After analyzing effective prevention programs, they estimated that a single dollar spent on prevention could save up to $18 in associated health care, education, and quality of life costs down the road.

In addition, funding for prevention only reflects a small fraction of all the money spent on substance abuse. A 2009 study by the National Center on Addiction and Substance Abuse at Columbia University found that prevention and treatment accounted for 1.9 percent—just over $7 billion—of federal and state funds for substance abuse and addiction. This paled in comparison to the $207 billion that was spent on health care associated with substance abuse.

Improving prevention

In communities across the country, the SAPST is already making a difference.

Alan Fredrickson supervises the implementation of regional SAPST trainings and monitors community prevention grants in his home state of Minnesota. He has a goal: ensure that each grantee organization features at least one staff member who is certified in substance abuse prevention.

Establishing a professional corps is not an easy task, however. “Prevention efforts are largely based on short-term grants, so there isn’t a lot of money or time being invested in prevention,” says Fredrickson. “We are trying to get prevention credentialing in Minnesota to be readily available and fairly low-cost."

Through regional trainings, Fredrickson has been using the SAPST to increase the pool of professionals who can manage Minnesota’s substance abuse prevention programs. The SAPST is even being offered at a handful of Minnesota colleges, preparing teachers, social workers, and health professionals before they formally enter their fields. And while funding for prevention programs can be volatile and is often the victim of cuts at the state level, Fredrickson believes that the SAPST can help his program staff do effective substance abuse prevention with fewer resources.

“The SAPST is built around assessment, capacity-building, planning, implementation, and evaluation,” he says. “I'm anxious to see what kind of new results we are going to have.”